{"id":28418,"date":"2025-07-18T04:55:00","date_gmt":"2025-07-17T20:55:00","guid":{"rendered":"https:\/\/csccm.org.cn\/?p=28418"},"modified":"2025-07-18T06:31:18","modified_gmt":"2025-07-17T22:31:18","slug":"chest%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e9%ab%98%e6%b5%81%e9%87%8f%e9%bc%bb%e5%af%bc%e7%ae%a1%e6%b0%a7%e7%96%97%e6%b5%81%e9%87%8f%e8%ae%be%e7%bd%ae%e5%af%b9%e6%8b%94%e7%ae%a1%e7%bb%93","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=28418","title":{"rendered":"[Chest\u53d1\u8868\u8bba\u6587]\uff1a\u9ad8\u6d41\u91cf\u9f3b\u5bfc\u7ba1\u6c27\u7597\u6d41\u91cf\u8bbe\u7f6e\u5bf9\u62d4\u7ba1\u7ed3\u5c40\u7684\u5f71\u54cd"},"content":{"rendered":"\n

CRITICAL CARE: ORIGINAL RESEARCH<\/strong>Volume 167,\u00a0Issue 5<\/a>P1388-1396 May 2025<\/p>\n\n\n\n

Effect of Flow Rates of High-Flow Nasal Cannula on Extubation Outcomes: A Randomized Controlled Trial<\/h1>\n\n\n\n

Sheng-Yuan\u00a0Ruan,\u00a0Yao-Wen\u00a0Kuo,\u00a0Chun-Ta\u00a0Huang,\u00a0et al<\/h3>\n\n\n\n

Chest 2025; 167: 1388-1396<\/h3>\n\n\n\n

Abstract<\/h2>\n\n\n\n

Background<\/h3>\n\n\n\n

High-flow nasal cannula (HFNC) has emerged as a promising intervention for postextubation oxygen therapy, with the potential to reduce the need for reintubation. However, it remains unclear whether using a higher flow setting provides better outcomes than the commonly used flow rate of 30 to 50 L\/min.<\/p>\n\n\n\n

Research Question<\/h3>\n\n\n\n

Does setting the flow rate of HFNC at 60 L\/min vs 40 L\/min for postextubation care result in different extubation outcomes?<\/p>\n\n\n\n

Study Design and Methods<\/h3>\n\n\n\n

This randomized controlled trial assigned intubated patients to receive HFNC at either a 60 L\/min or 40 L\/min flow rate following extubation. The assigned flow rate was maintained for 24 hours. The primary outcome was a composite of reintubation or the use of noninvasive ventilation (NIV) within 48 hours\u2019 after extubation. Key secondary outcomes included ahead-of-schedule changes in HFNC settings and mortality.<\/p>\n\n\n\n

Results<\/h3>\n\n\n\n

A total of 180 patients were randomized; 169 were included in the analysis (86 in the 40 L\/min group and 83 in the 60 L\/min group). The primary outcome events occurred in 19 patients (22.1%) in the 40 L\/min group and in 14 patients (16.9%) in the 60 L\/min group (risk difference, 5.2%; 95%\u00a0CI, \u20136.7%\u00a0to 17.1%;\u00a0P<\/em>\u00a0= .39). For secondary outcomes, the 40 L\/min group was associated with a higher risk of escalation in respiratory support, defined as using NIV or up-titration of HFNC settings (24 [27.9%] vs\u00a08 [9.6%];\u00a0P<\/em>\u00a0= .002).<\/p>\n\n\n\n

\"\"\/<\/figure>\n\n\n\n
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Interpretation<\/h3>\n\n\n\n

In unselected extubated patients, setting the HFNC flow rate at 60 L\/min did not reduce the risk of reintubation or NIV use compared with a flow rate of 40 L\/min. Using a flow rate of 40 L\/min with as-needed up-titration may be a reasonable alternative to setting the flow at 60 L\/min for postextubation care. However, this trial may not have been sufficiently powered to exclude a small between-group difference.<\/p>\n\n\n\n

Clinical Trial Registration<\/h3>\n\n\n\n

ClinicalTrials.gov; No.: NCT04934163; URL: www.clinicaltrials.gov<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"

CRITICAL CARE: ORIGINAL RESEARCHVolume 167,\u00a0Issue 5P138 […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/28418"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=28418"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/28418\/revisions"}],"predecessor-version":[{"id":28419,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/28418\/revisions\/28419"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=28418"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=28418"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=28418"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}